Status etter innføring av en standardisert behandlingsprotokoll, inklusive terapeutisk hypotermi, etter vellykket gjenopplivet pre-hospital hjertestans ved UUS.

Abstract

Background: In a study from Norway from 2003, the survival rate after admission to ICU following successful resuscitation after out-of-hospital cardiac arrest (OHCA) was 56% in Stavanger and only 34% in Oslo. Therefore, a new treatment protocol was introduced at Ullevaal Universitetssykehus (UUS) including therapeutic hypothermia and a more aggressive treatment of the underlying cause. The aim of this study was to assess the results and evaluate the treatment after the introduction of this new protocol. Material and methods: The journals of all patients admitted to the emergency department at UUS after OHCA in the period of 01.09.03 – 01.12.04 were examined retrospectively. The main focus was overall results, but the general implementation and especially performance of the therapeutic hypothermia including side effects were of great interest. Results: A total of 92 patients were brought to the emergency room at UUS, and 25 of these were declared dead in the emergency room and one patient died during the PCI-procedure. A total of 66 patients were admitted to different ICUs, and 34 of these (52%) were discharged alive. Of those admitted to ICU, 51 patients (77%) had a cardiac cause and 32 (63%) were discharged alive. Altogether 41 (61%) patients were treated with therapeutic hypothermia, and 29 (%) patients received PCI-treatment. Of all discharged patients 97 % had a CPC-score of one or two. Conclusion: Survival and cerebral performance after successful resuscitation after OHCA is considerably improved after the establishment of a standardised treatment protocol focusing on vital organ perfusion.